How we’re helping plans improve adherence amid COVID-19

Over the past year, we have seen adherence numbers trending upwards for one of our Medicare clients in Puerto Rico. Under normal circumstances, these numbers are impressive but, seeing this year-over-year growth amid a worldwide pandemic when people have been ordered to stay-at-home is almost unheard of.

While it is too soon to determine the exact cause for these trends, we believe that two driving forces are emerging: empowering pharmacies and increasing collaboration.

Here are a few of the initiatives that may be extending the adherence curve for this plan:

  • A deeper commitment to pharmacy education. Over the last year, Abarca has doubled the size of its Provider Education Unit and increased its investment in this initiative. This department is tasked with creating and disseminating information that pharmacies and providers need to deliver better outcomes for members and health plans. For example, patients who are suffering from high cholesterol might not exhibit any obvious symptoms when their health is declining, so Abarca’s team provides pharmacists with more nuanced information about warning signs that may warrant intervention. Moreover, since the start of the COVID-19 public health crisis, the team has been holding daily education sessions with our pharmacy network to answer pharmacists’ questions about adherence and other pressing topics related to the pandemic, and provide resources in real-time.
  • Rewarding pharmacies for their help in improving adherence. The RxTarget pharmacy program gives pharmacists the technology and visibility they need to impact member adherence meaningfully. Now in its second year, this program is powered by a module of Darwin that allows pharmacists to access advanced analytics and reporting, prioritize members who may require intervention, track their progress throughout the year, and earn financial bonuses based on their performance. In the program’s first year, during which we used the DIR model to determine rewards and penalties, participating health plans saw a year-over-year increase in adherence of up to 3%–and early data is indicating that number could be even higher in 2020.
  • Open and ongoing communication. Abarca provides our client with weekly updates of its pharmacy network’s progress with the RxTarget program. This ensures that we maintain a clear pathway with the health plan on the results, and allows us to make timely recommendations and decisions about any course corrections that need to be made. These updates include detailed reports that monitor adherence by month and, when necessary, also delve into information on the performance of their medical groups (IPAs) to help them proactively engage in initiatives.And, while traditional pharmacy benefit managers focus on payer relations, Abarca is making a concerted effort to understand the challenges and opportunities presented to healthcare providers as well. That’s why we have established bi-weekly provider calls to find opportunities to collaborate and innovate.

While our team continues to track adherence–and determine any change drivers–for all of our members, we are encouraged by the improvements we have seen so far, and that we have been able to work with our clients and pharmacy network to achieve these results even amid a public health crisis. In the meantime, we won’t stop trying to improve and find even better ways to serve our clients and the lives they serve.

This blog was written by Ana M. Rivera, PharmD, Clinical Programs Manager at Abarca.


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